Abstract
BackgroundThe insurgency tactics that characterize modern warfare, such as suicide car bombs and roadside bombs, have the potential to significantly impact road traffic injuries in conflict affected-countries. As road traffic incidents are one of the top ten causes of death in Iraq, changes in incidence have important implications for the health system. We aimed to describe patterns of road traffic fatalities for all demographic groups and types of road users in Iraq during a period characterized by a resurgence in insurgency activity.MethodsIraqi Ministry of Health routine prospective injury surveillance collects information on all fatal injuries in eight governorates of Iraq: Baghdad, Al-Anbar, Basrah, Erbil, Kerbala, Maysan, Ninevah, and Al-Sulaimaniya. From all injury fatalities documented at the coroner office, we analyzed only those attributed to road traffic that occurred between 1 January 2010 and 31 December 2013. Coroners ascertain information from physical examinations, police reports and family members.ResultsAnalysis included 7,976 road traffic fatalities. Overall, 6,238 (78.2 %) fatalities were male and 2,272 (28.5 %) were children under 18 years of age. The highest numbers of road traffic fatalities were among males 15 to 34 years of age and children of both sexes under 5 years of age. 49.2 % of fatalities occurred among pedestrians. Among children and females, the majority of road traffic fatalities were pedestrians, 69.0 % and 56.6 %, respectively. Fatalities among motorcyclists (3.7 %) and bicyclists (0.4 %) were least common. Rates of road traffic fatalities ranged from 8.6 to 10.7 per 100,000 population.ConclusionsThe injury surveillance system provides the first data from a conflict-affected country on road traffic fatalities disaggregated by type of road user. The highest numbers of fatalities were among children and young men. Nearly half of fatalities were pedestrians, a proportion nearly double that of any neighboring country. As insurgency activity increased in 2013, the number of road traffic fatalities declined.
Highlights
The insurgency tactics that characterize modern warfare, such as suicide car bombs and roadside bombs, have the potential to significantly impact road traffic injuries in conflict affected-countries
Data on fatal injuries caused by road traffic injuries between January 1, 2010 and December 31, 2013 were obtained from the Injury Mortality Surveillance System operated by the Iraqi Ministry of Health (MoH)
ARate per 100,000; annual population projections from the most recent census published by the Iraqi Central Statistics Organization (COSIT) b% refers to fatal injuries from road traffic injuries (RTI) as a percentage of all fatal injuries reported at the coroner office terms of the total number and population-based rates of road traffic fatalities as well as the proportion of road traffic fatalities among fatal injuries of any cause recorded in coroner offices, by year and governorate
Summary
The insurgency tactics that characterize modern warfare, such as suicide car bombs and roadside bombs, have the potential to significantly impact road traffic injuries in conflict affected-countries. As road traffic incidents are one of the top ten causes of death in Iraq, changes in incidence have important implications for the health system. Even in conflict-affected countries such as Afghanistan, Libya, Pakistan, and Yemen, road traffic remains the most common mechanism of injury fatality, causing between two and eight times more fatalities than forces of war and legal intervention [3]. The World Health Organization (WHO) estimates the traffic fatality rate in the Eastern Mediterranean Region (EMR) to be the second highest rate globally after the African Region, and increasing in several of the countries in the region [1, 4]. Iraq has the second highest road traffic fatality rate within the EMR [1].
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